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Elmugadam FM, Ahmed H, KARAMELGHANI MOHAMMED, Ali A, Ali I, Ahmed A, Salman M, Mohamed W, Ahmed EA, Abbasher Hussien Mohamed Ahmed K, Mustafa Ahmed GE, Elsayed L, Musa A. Awareness of consanguineous marriage burden and willingness towards premarital genetic testing in Sudan: a national cross-sectional study. Ann Med Surg (Lond) 2024; 86:3959-3971. [PMID: 38989216 PMCID: PMC11230780 DOI: 10.1097/ms9.0000000000002210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/14/2024] [Indexed: 07/12/2024] Open
Abstract
Background Despite the widespread practice of consanguinity in Sudan, there is a lack of exploration into the community's awareness of its health implications on offspring and their overall attitude towards consanguineous unions. Aim This study aimed to evaluate the community's awareness of the possible health adversities of consanguinity on children and assess the effect of knowledge level on the prevailing attitude towards this practice in Sudan. Methods From August to December 2018, data were collected from adults aged 18 years and above in five provinces of Sudan regardless of their marital status. The analysis involved both descriptive and multivariate statistical techniques. Results This study revealed a consanguinity rate of 30.2%. Despite a high awareness level (73.7%) regarding the effects of consanguineous marriage on the health of the offspring, a moderately negative attitude towards this practice (63.9%) was observed. Conclusion The discordance between the high consanguinity rate in the Sudanese population and the moderately negative attitude suggests a potential persistence of this practice in the future. Without the implementation of educational programs and the provision of genetic counselling services to consanguineous couples, the prevalence of consanguinity is likely to endure.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Liena Elsayed
- Department of Basic Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ahmed Musa
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
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Therrell BL, Padilla CD, Borrajo GJC, Khneisser I, Schielen PCJI, Knight-Madden J, Malherbe HL, Kase M. Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020-2023). Int J Neonatal Screen 2024; 10:38. [PMID: 38920845 PMCID: PMC11203842 DOI: 10.3390/ijns10020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 06/27/2024] Open
Abstract
Newborn bloodspot screening (NBS) began in the early 1960s based on the work of Dr. Robert "Bob" Guthrie in Buffalo, NY, USA. His development of a screening test for phenylketonuria on blood absorbed onto a special filter paper and transported to a remote testing laboratory began it all. Expansion of NBS to large numbers of asymptomatic congenital conditions flourishes in many settings while it has not yet been realized in others. The need for NBS as an efficient and effective public health prevention strategy that contributes to lowered morbidity and mortality wherever it is sustained is well known in the medical field but not necessarily by political policy makers. Acknowledging the value of national NBS reports published in 2007, the authors collaborated to create a worldwide NBS update in 2015. In a continuing attempt to review the progress of NBS globally, and to move towards a more harmonized and equitable screening system, we have updated our 2015 report with information available at the beginning of 2024. Reports on sub-Saharan Africa and the Caribbean, missing in 2015, have been included. Tables popular in the previous report have been updated with an eye towards harmonized comparisons. To emphasize areas needing attention globally, we have used regional tables containing similar listings of conditions screened, numbers of screening laboratories, and time at which specimen collection is recommended. Discussions are limited to bloodspot screening.
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Affiliation(s)
- Bradford L. Therrell
- Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
- National Newborn Screening and Global Resource Center, Austin, TX 78759, USA
| | - Carmencita D. Padilla
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines;
| | - Gustavo J. C. Borrajo
- Detección de Errores Congénitos—Fundación Bioquímica Argentina, La Plata 1908, Argentina;
| | - Issam Khneisser
- Jacques LOISELET Genetic and Genomic Medical Center, Faculty of Medicine, Saint Joseph University, Beirut 1104 2020, Lebanon;
| | - Peter C. J. I. Schielen
- Office of the International Society for Neonatal Screening, Reigerskamp 273, 3607 HP Maarssen, The Netherlands;
| | - Jennifer Knight-Madden
- Caribbean Institute for Health Research—Sickle Cell Unit, The University of the West Indies, Mona, Kingston 7, Jamaica;
| | - Helen L. Malherbe
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa;
- Rare Diseases South Africa NPC, The Station Office, Bryanston, Sandton 2021, South Africa
| | - Marika Kase
- Strategic Initiatives Reproductive Health, Revvity, PL10, 10101 Turku, Finland;
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Halawani SH, Khan SA, Al Zughaibi TA, Khan SA. Attitude and Behavior of Parents of Children With Sickle Cell Disease Toward the Disease: An Observational Study in Saudi Arabia. Cureus 2024; 16:e55552. [PMID: 38576648 PMCID: PMC10993756 DOI: 10.7759/cureus.55552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a significant hematological disorder affecting populations worldwide, with a notable prevalence in certain regions of Saudi Arabia. Despite extensive screening programs, there is a critical need for improved public health education to enhance understanding and management of SCD. This study examines the relationship between the attitudes and behaviors of parents toward their children's disease and its management. METHODS We conducted a cross-sectional observational study at the King Fahd Medical Research Center in Jeddah. This research encompassed children aged 5-16 years with SCD and their parents. Comprehensive questionnaires assessed sociodemographic data, attitudes toward SCD, and behavioral responses to the illness and treatment. RESULTS The study included 66 parents, predominantly in the age range of 30-39 years and earning below 5000 Saudi Riyals, who exhibited varying attitudes towards SCD, with a majority questioning the availability of a cure and expressing caution towards new treatments. Despite a cautious approach to invasive treatments, parents relied on information from healthcare providers. Attitudes towards treatment showed significant differences based on gender and education level, with females and less-educated parents exhibiting more hesitancy towards new treatment and blood transfusions. CONCLUSION The study indicates that while parents show a positive and proactive attitude toward SCD, there is hesitancy towards new and invasive treatments, reflecting the need for continued educational support. The results underscore the importance of tailored healthcare communication strategies to address the diverse needs of families affected by SCD.
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Affiliation(s)
- Saeed H Halawani
- Department of Hematology and Immunology, Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Shahida A Khan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, SAU
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | - Torki A Al Zughaibi
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, SAU
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | - Sarah A Khan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, SAU
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Abdel Razeq NM, Ali RA, Aqel A, Pack-Mabien AV, Sabbah EA, Qadiri IA, Aldasoqi KY. Nurses' Attitudes Concerning Analgesia Administration for Pediatric Patients with Sickle Cell Disease in Jordan: A Cross-Sectional Study. Pain Manag Nurs 2024; 25:e29-e36. [PMID: 37648575 DOI: 10.1016/j.pmn.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 08/05/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Pain management of vaso-occlusive crises is a fundamental priority in the lifelong care of children and adolescents with sickle cell disease. AIM This study examined nurses' attitudes towards caring for children with sickle cell disease (SCD) and SCD pain management in those with vaso-occlusive pain. METHOD A structured, self-reporting survey was provided to a convenience sample of 298 nurses across 10 hospitals serving Jordan's northern and middle regions. Descriptive and inferential statistics were applied for data analysis. RESULTS Most nurses (77%) perceived their experience caring for children with SCD as positive. Many nurses (65%) felt frustrated about caring for these children during painful episodes. Participants identified workload and inadequate time as limiting their ability to address the analgesic needs of children with SCD. Receiving structured education specialized in pain management and more years of experience in nursing significantly predicted less hesitancy in administering opioid-based analgesia. CONCLUSIONS The results of this study provided further insight into factors that potentially contribute to vaso-occlusive pain crises frequently being poorly managed and inadequately addressed among pediatric patients. Nurses' attitudes and understanding of SCD pain management must be addressed to advance the clinical practice of managing pain in children with SCD.
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Affiliation(s)
- Nadin M Abdel Razeq
- The University of Jordan - School of Nursing, Maternal and Child Health Nursing Department, Amman, 11942, Jordan.
| | - Reem A Ali
- Maternal and Child Health Nursing Department, School of Nursing Jordan University of Science and Technology, Irbid, Jordan.
| | - Ahmad Aqel
- Department School of Nursing, The University of Jordan, Amman, Jordan.
| | - Ardie Vanessa Pack-Mabien
- University of South Alabama Health, Johnson Haynes, Jr., MD Comprehensive Sickle Cell Center, 2451 University Hospital Drive, MCSB 1530, Mobile, 36617, Alabama.
| | - Eman Abu Sabbah
- Maternal and Child Health Nursing Department, School of Nursing The University of Jordan, Amman, Jordan.
| | - Inshirah A Qadiri
- Maternal and Child Health Nursing Department, School of Nursing The University of Jordan, Amman, Jordan.
| | - Khadeejeh Y Aldasoqi
- Maternal and Child Health Nursing Department, School of Nursing The University of Jordan, Amman, Jordan.
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Colombatti R, Hegemann I, Medici M, Birkegård C. Systematic Literature Review Shows Gaps in Data on Global Prevalence and Birth Prevalence of Sickle Cell Disease and Sickle Cell Trait: Call for Action to Scale Up and Harmonize Data Collection. J Clin Med 2023; 12:5538. [PMID: 37685604 PMCID: PMC10488271 DOI: 10.3390/jcm12175538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited monogenic disorder with high prevalence throughout sub-Saharan Africa, the Mediterranean basin, the Middle East, and India. Sources of SCD epidemiology remain scarce and fragmented. A systematic literature review (SLR) to identify peer-reviewed studies on SCD epidemiology was performed, with a search of bibliographic databases and key conference proceedings from 1 January 2010 to 25 March 2022 (congress abstracts after 2018). The SLR followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses, using a binomial normal random-effects model, were performed to estimate global and regional prevalence and birth prevalence. Of 1770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria. Prevalence was highest in Africa (~800/100,000), followed by the Middle East (~200/100,000) and India (~100/100,000), in contrast to ~30/100,000 in Europe. Birth prevalence was highest in Africa (~1000/100,000) and lowest in North America (~50/100,000) and Europe (~30/100,000). This SLR confirmed that sub-Saharan and North-East Africa, India, the Middle East, and the Caribbean islands are global SCD hotspots. Publications including mortality data were sparse, and no conclusions could be drawn about mortality. The identified data were limited due to gaps in the published literature for large parts of the world population; the inconsistent reporting of SCD genotypes, diagnostic criteria, and settings; and a sparsity of peer-reviewed publications from countries with assumed high prevalence. This SLR demonstrated a lack of systematic knowledge and a need to provide uniform data collection on SCD prevalence and mortality.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Child and Maternal Health, Azienda Ospedaliera, University of Padova, 35122 Padua, Italy
| | | | - Morten Medici
- Novo Nordisk A/S, 2860 Søborg, Denmark; (M.M.); (C.B.)
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Elhadi YAM, Alrawa SS, Alfadul ESA, Mahgoub EAA, El-Osta A, Belal SA, Lucero-Prisno DE, El Dabbah NA, Yahia A. Consanguinity and willingness to perform premarital genetic screening in Sudan. Eur J Hum Genet 2023:10.1038/s41431-023-01438-1. [PMID: 37528188 DOI: 10.1038/s41431-023-01438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023] Open
Abstract
Consanguineous marriage is prevalent in certain world regions due to cultural, economic, and social reasons. However, it can lead to negative consequences including an increased risk of genetic disorders in offspring. Premarital genetic screening (PMGS) is an important tool to identify and manage these risks before marriage. This study aimed to assess the magnitude of consanguineous marriage, knowledge of genetic diseases and PMGS, and attitudes and willingness to perform PMGS in Sudan. A national household survey was conducted using a multistage sampling technique, with a sample size of 2272 participants. Data were collected from December 2022 to March 2023 using an interviewer-administered questionnaire. A significant proportion of respondents (364/850, 42.8%) were married to consanguineal partners, with various types of relatedness. Moreover, 32.1% (242/755) of single respondents were planning to marry a close relative, signifying the likely persistence of consanguineous marriages in Sudan. The level of knowledge regarding genetic diseases and PMGS was relatively low in many states of Sudan, indicating the need for increased awareness interventions. A significant number of participants (85.2%) agreed that premarital screening is effective in reducing genetic diseases, whereas 71.2% supported the introduction of a mandatory PMGS program. Excluding married participants, 82.3% (1265/1537) of respondents were willing to perform PMGS, if implemented. These findings reflect the public positive attitude towards introducing the PMGS program and policies in Sudan and underscore the importance of addressing the knowledge gap of PMGS before such a potential implementation.
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Affiliation(s)
| | - Salma S Alrawa
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | | | - Austen El-Osta
- Self-Care Academic Research Unit (SCARU), School of Public Health, Imperial College London, London, UK
| | | | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Noha Ahmed El Dabbah
- Department of Health Administration and Behavioural Sciences, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ashraf Yahia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Solna, Sweden.
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7
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Adigwe OP, Onoja SO, Onavbavba G. A Critical Review of Sickle Cell Disease Burden and Challenges in Sub-Saharan Africa. J Blood Med 2023; 14:367-376. [PMID: 37284610 PMCID: PMC10239624 DOI: 10.2147/jbm.s406196] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/21/2023] [Indexed: 06/08/2023] Open
Abstract
Sickle cell disease is caused by an abnormality of the β-globin gene and is characterised by sickling of the red blood cells. Globally, sub-Saharan African countries share the highest burden of the disease. This study aimed at critically reviewing studies focusing on challenges of sickle cell anaemia in sub-Saharan Africa. A literature search was carried out in five major databases. Articles that met the inclusion criteria were included in the bibliometric review and critical analysis. A majority of the studies were undertaken in the West African region (85.5%), followed by Central Africa (9.1%). Very few studies had been undertaken in East Africa (3.6%), whilst the Southern African region had the fewest studies (1.8%). Distribution in relation to country revealed that three quarters of the studies were carried out in Nigeria (74.5%), followed by the Democratic Republic of the Congo (9.1%). According to healthcare settings, a strong majority of the studies were undertaken in tertiary health care facilities (92.7%). Major themes that emerged from the review include interventions, cost of treatment, and knowledge about sickle cell disease. Public health awareness and promotion as well as improving the quality of sickle cell centers for prompt management of patients with sickle cell disorder was identified as a critical strategy towards reducing the burden of the disease in sub-Saharan Africa. To achieve this, governments in countries located in this region need to adopt a proactive strategy in addressing gaps that have been identified in this study, as well as instituting other relevant measures, such as continuous media engagement and public health interventions relating to genetic counselling. Reforms in other areas that can help reduce the disease burden, include training of practitioners and equipping sickle cell disease treatment centers according to World Health Organization specifications.
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Affiliation(s)
- Obi Peter Adigwe
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
| | - Solomon Oloche Onoja
- Department of Medical Laboratory Sciences, University of Nigeria, Enugu, Nigeria
| | - Godspower Onavbavba
- Office of the Director General, National Institute for Pharmaceutical Research and Development, Abuja, Federal Capital Territory, Nigeria
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Yahia A, Hamed AAA, Mohamed IN, Elseed MA, Salih MA, El-Sadig SM, Siddig HE, Nasreldien AEM, Abdullah MA, Elzubair M, Omer FY, Bakhiet AM, Abubaker R, Abozar F, Adil R, Emad S, Musallam MA, Eltazi IZM, Omer Z, Malik H, Mohamed MOE, Elhassan AA, Mohamed EOE, Ahmed AKMA, Ahmed EAA, Eltaraifee E, Hussein BK, Abd Allah ASI, Salah L, Nimir M, Tag Elseed OM, Elhassan TEA, Elbashier A, Alfadul ESA, Fadul M, Ali KF, Taha SOMA, Bushara EE, Amin M, Koko M, Ibrahim ME, Ahmed AE, Elsayed LEO, Stevanin G. Clinical phenotyping and genetic diagnosis of a large cohort of Sudanese families with hereditary spinocerebellar degenerations. Eur J Hum Genet 2023:10.1038/s41431-023-01344-6. [PMID: 37012327 DOI: 10.1038/s41431-023-01344-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/12/2023] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Hereditary spinocerebellar degenerations (SCDs) is an umbrella term that covers a group of monogenic conditions that share common pathogenic mechanisms and include hereditary spastic paraplegia (HSP), cerebellar ataxia, and spinocerebellar ataxia. They are often complicated with axonal neuropathy and/or intellectual impairment and overlap with many neurological conditions, including neurodevelopmental disorders. More than 200 genes and loci inherited through all modes of Mendelian inheritance are known. Autosomal recessive inheritance predominates in consanguineous communities; however, autosomal dominant and X-linked inheritance can also occur. Sudan is inhabited by genetically diverse populations, yet it has high consanguinity rates. We used next-generation sequencing, genotyping, bioinformatics analysis, and candidate gene approaches to study 90 affected patients from 38 unrelated Sudanese families segregating multiple forms of SCDs. The age-at-onset in our cohort ranged from birth to 35 years; however, most patients manifested childhood-onset diseases (the mean and median ages at onset were 7.5 and 3 years, respectively). We reached the genetic diagnosis in 63% and possibly up to 73% of the studied families when considering variants of unknown significance. Combining the present data with our previous analysis of 25 Sudanese HSP families, the success rate reached 52-59% (31-35/59 families). In this article we report candidate variants in genes previously known to be associated with SCDs or other phenotypically related monogenic disorders. We also highlight the genetic and clinical heterogeneity of SCDs in Sudan, as we did not identify a major causative gene in our cohort, and the potential for discovering novel SCD genes in this population.
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Affiliation(s)
- Ashraf Yahia
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
- Paris Brain Institute - ICM, CNRS UMR7225, INSERM 1127, Sorbonne University, F-75000, Paris, France.
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Solna, Sweden.
| | - Ahlam A A Hamed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Inaam N Mohamed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Maha A Elseed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mustafa A Salih
- Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- College of Medicine, AlMughtaribeen University, Khartoum, Sudan
| | | | | | - Ali Elsir Musa Nasreldien
- Pediatric Neurology Department, Red Cross Memorial Children Hospital (RCWMCH), University of Cape Town (UCT), Cape Town, South Africa
| | | | - Maha Elzubair
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | | | - Rayan Abubaker
- Sudanese Neurogenetics Research group, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- National University Biomedical Research Institute, National University, Khartoum, Sudan
| | - Fatima Abozar
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rawaa Adil
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Sara Emad
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Isra Z M Eltazi
- Neurology Department, Hamad Medical Corporation, Doha, Qatar
| | - Zulfa Omer
- Department of Hematology and Medical Oncology, University of Cincinnati Medical Center, Ohio, USA
| | - Hiba Malik
- Department of Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Mayada O E Mohamed
- Division of Emergency Medicine, Sudan Medical Specialization Board, Khartoum, Sudan
| | - Ali A Elhassan
- Sudan Neuroscience Projects, University of Khartoum, Khartoum, Sudan
| | | | - Ahmed K M A Ahmed
- Department of Molecular Neuroscience, Graduate school of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
- WPI Immunology Frontier Research Center, Osaka University, 3-1, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | | | | | - Bidour K Hussein
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Lina Salah
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed Nimir
- Department of Pathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | | | | | | | | | - Moneeb Fadul
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Khalil F Ali
- Department of Cardiology, Royal Derby Hospital, Derby, UK
| | | | | | - Mutaz Amin
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
| | - Mahmoud Koko
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Ammar E Ahmed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Liena E O Elsayed
- Department of Basic Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, P.O.Box 84428, Riyadh, 11671, Saudi Arabia
| | - Giovanni Stevanin
- Paris Brain Institute - ICM, CNRS UMR7225, INSERM 1127, Sorbonne University, F-75000, Paris, France.
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000, Bordeaux, France.
- EPHE, PSL Research university, CNRS, INCIA, UMR 5287, F-75000, Paris, France.
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9
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Ohemeng A, Nartey EB, Quaidoo E, Ansong RS, Asiedu MS. Knowledge and nutrition-related practices among caregivers of adolescents with sickle cell disease in the Greater Accra region of Ghana. BMC Public Health 2023; 23:434. [PMID: 36879231 PMCID: PMC9990343 DOI: 10.1186/s12889-023-15343-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Due to its severe adverse effect on child mortality, sickle cell disease (SCD) has been identified as a set of diseases of public health concern. The high mortality rate among children with SCD in Africa has been attributed to several factors including sub-optimal management and care. This study documented the nutrition-related knowledge and practices of caregivers of teenagers who suffer from sickle cell disease (SCD) to inform decisions on integrated management of the disease. METHODS The study included caregivers (n = 225) of adolescents with SCD who attended clinic at selected hospitals in Accra, Ghana. Pre-tested semi-structured questionnaire was employed in the gathering of information related to general and nutrition-related knowledge about SCD, as well as data on their nutrition-related practices with regards to their children who suffer from SCD. Pearson's Chi-square test and binary logistic regression analyses were applied to explore the relationship between caregivers' nutrition-related knowledge and practice. RESULTS Nutrition-related knowledge among the caregivers studied was low, with less than a third of them (29.3%) of the sample being classified as having good knowledge. Caregivers who considered nutrition care when the child experienced crises were few (21.8%), and those with low nutrition-related knowledge were less likely to do this compared with caregivers having high knowledge (OR = 0.37, 95% CI = 0.18, 0.78). The common nutrition actions reported were the provision of more fruits/fruit juices (36.5%) and warm fluids such as soups and teas (31.7%). More than a third of the caregivers (38.7%) admitted that they faced challenges in caring for their adolescents with SCD, particularly in the area of finance for the needed health care. CONCLUSION Our study findings indicate that it is important to incorporate appropriate nutrition education messages for caregivers as part of a holistic management of SCD.
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Affiliation(s)
- Agartha Ohemeng
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Eunice Berko Nartey
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon Boundary, Accra, Ghana
| | - Esi Quaidoo
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Richard Stephen Ansong
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon Boundary, Accra, Ghana
| | - Matilda Steiner Asiedu
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon Boundary, Accra, Ghana
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10
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Ali EH, Alkindi S, Mohamed AO, Awadalla KE, Abdlgadir O, Adam G, Magdi M, Ibrahim AK, Ghebremeskel K. Adverse Pregnancy Outcomes in Sickle Cell Trait: a Prospective Cohort Study Evaluating Clinical and Haematological Parameters in Postpartum Mothers and Newborns. Mediterr J Hematol Infect Dis 2023; 15:e2023002. [PMID: 36660349 PMCID: PMC9833303 DOI: 10.4084/mjhid.2023.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023] Open
Abstract
Background Sickle cell trait (SCT) is a congenital condition caused by the inheritance of a single allele of the abnormal haemoglobin beta gene, HbS. Carriers of SCT are generally asymptomatic, and they do not manifest the clinical and haematological abnormalities of sickle cell anaemia (SCA). However, there is evidence that they display some symptoms in stressful situations. Pregnancy is a stressful physiological event, and it is not clear if SCT adversely affects pregnancy outcomes, particularly in those from developing countries where people regularly suffer from nutritional insufficiency. Objective This study aims to investigate pregnancy outcomes in Sudanese women with SCT. Subjects and methods: Pregnant women with (HbAS, n=34) and without (HbAA, n=60) SCT were recruited during their first trimester at El Obeid Hospital, Kordofan, Western Sudan. Following appropriate ethical approval and informed consent from the participants, detailed anthropometric, clinical, haematological, obstetric, and birth outcome data were registered. In addition, blood samples were collected at enrolment and at delivery. Results At enrolment in the first trimester, the SCT group did not manifest SCA symptoms, and there was no difference in the haematological parameters between the SCT and control groups. However, at delivery, the women with SCT, compared with the control group, had lower levels of hemoglobin (Hb, p=0.000), packed cell volume (PCV, p=0.000), mean corpuscular haemoglobin (MCH, p=0.002) and neutrophil counts (p=0.045) and higher mean corpuscular volume (MCV, p=0.000) and platelet counts (p=0.000). Similarly, at delivery, the babies of SCT women had lower birth weight (p=0.000), lower Hb (p=0.045), PCV (p=0.000), MCH (p=0.000), and higher neutrophil (p=0.004) and platelet counts (p=0.000) than the babies of the healthy control group. Additionally, there were more miscarriages, stillbirths, and admissions to the Special Care Baby Unit (SCBU) in the SCT group. Conclusions The study revealed that SCT is associated with adverse pregnancy outcomes, including maternal and neonatal anaemia, low birth weight, and increased risk of stillbirth, miscarriage, and admission to SCBU. Therefore, pregnant women with SCT should be given appropriate pre-conceptual advice and multidisciplinary antenatal and postnatal care.
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Affiliation(s)
- E H Ali
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
| | - S Alkindi
- Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - A O Mohamed
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Sudan
| | | | - O Abdlgadir
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - G Adam
- Faculty of Education, Al Azhri University, Sudan
| | - M Magdi
- Directorate of Planning, Ministry of Health Oman, Muscat, Sultanate of Oman
| | - A K Ibrahim
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - K Ghebremeskel
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
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Mutua B, Sowayi G, Okoth P. Distribution of hemoglobinopathy phenotypes in western Kenya: a retrospective study done at Aga Khan Hospital, Kisumu. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00138-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Hemoglobinopathies are inheritable disorders of hemoglobin and are the most common genetic defects in humans. This is a neglected public health problem whose undiagnosis remain a major threat to its prevention and control in sub-Saharan Africa countries; thus its exact magnitude on morbidity and mortality remains poorly documented. These hemoglobin disorders have been associated with Plasmodium falciparum; therefore, the current study sought to determine its distribution in a malaria-holoendemic region of Western Kenya as part of remedial intervention recommended by World Health Organization (WHO).
Method
This study analyzed data conveniently selected through census from 2015 to 2020 from hematology laboratory database for patients examined in Aga Khan, Hospital, Kisumu, and its satellites in Western Kenya. A total of 247 cases were selected whose sample size was calculated using Cochran’s formula. Distribution of hemoglobinopathies based on stations, gender, and age was expressed in frequencies, proportions, bar graphs, and pie charts.
Results
The distribution of hemoglobinopathies had varying proportions in different locations in Western Kenya with regions that were at proximity to Lake Victoria (Kisumu 41.3%, n = 102; Busia 21.5%, n = 53; Homabay 15.4%, n = 38) recording a higher overall hemoglobinopathy proportions than those that were far from the lake that include Bungoma 5.7%, n = 14; Kakamega 4.0%, n = 10; Kitale 4.0%, n = 10; Kisii 4.0%, n = 10, and Migori 4.0% n = 10.
Conclusion
The study represents the burden of hemoglobinopathies in a malaria-holoendemic region of Western Kenya, and even though the present study did not include ethnicity in data collection, stations from where the data was collected are predominated by different communities; therefore, there may be an ethnic correlation in the variation of hemoglobinopathies in Western Kenya. The communities juxtaposed to the lake seems to be the most affected ethnic group along the Lake Victoria economic block region; thus, it may be erroneous to assume that the entire malaria-holoendemic region of Western Kenya has high prevalence of hemoglobin disorders without factoring ethnicity and geographical location in a properly conducted population-based prevalence study in the wider Western Kenya.
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Mustafa AEM, Tahir NM, Ahmed Mohamed NAE, Mohammed AA, Mohammed SI. Deep Vein Thrombosis of the Left Lower Limb in a Sudanese Child with Sickle Cell Disease. MEDICINES (BASEL, SWITZERLAND) 2022; 9:52. [PMID: 36355057 PMCID: PMC9697196 DOI: 10.3390/medicines9110052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This is a case of an eleven-year-old female Sudanese child, a known Sickle Cell Anemia (SCA) patient, who presented with fever, as well as left thigh and leg swelling that was associated with pain and warmness, which was diagnosed as Deep Vein Thrombosis (DVT) of her left lower limb. She had a previous history of admissions to the emergency room, during which she once received blood. The patient was managed by carrying out a basic routine initial laboratory investigation. A Doppler ultrasound scan showed features consistent with DVT. Based on the clinical findings and investigation results, management began by providing the patient with intravenous fluid, analgesia, packed Red Blood Cells (RBCs), intravenous antibiotics, and low-molecular-weight heparin. Further consultations showed that there was no need for vascular surgery or surgical intervention. This case highlights the need for more studies on DVT and Venous Thromboembolism (VTE) complications in children with SCA, so as to develop strategies for diagnosis and management in order to reduce the risk of life-threatening complications of VTE in patients with Sickle Cell Disease SCD.
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Affiliation(s)
- Alam Eldin Musa Mustafa
- Department of Child Health, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Kordofan University, P.O. Box 160, El Obeid 51111, Sudan
| | - Niemat Mohammed Tahir
- Department of Child Health, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
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Khalafallah TO, Ajab Eldoor AA, Babker AM, Bin Shaya AS, Alfahed A, Alharithi NS, Aloraini GS, Waggiallah HA. Hematological and molecular analyses of the HbS allele among the Sudanese population. J Int Med Res 2022; 50:3000605221125050. [PMID: 36134571 PMCID: PMC9502246 DOI: 10.1177/03000605221125050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective The purpose of this study was to perform hematological and molecular analyses of the HbS allele of the hemoglobin subunit beta gene in the Sudanese population. Methods This was a descriptive cross-sectional study. Hematological parameters and fetal hemoglobin (HbF) levels were assessed in all participants. Data were gathered through the use of questionnaires and laboratory investigations. The βS-globin haplotypes, S allele distributions, and hematological parameters with HbF levels were investigated using PCR-restriction fragment length polymorphism, gel electrophoresis, and a Sysmex hematology analyzer, respectively. Results According to our findings, the Bantu (BA) haplotype was found in 10.8% of participants with homozygous uncontested haplotypes, followed by Benin (BA) and Sudan (SU), each in 9.8% of participants. This Sudanese group from Northern Kordofan lacked the Arab-Indian haplotype. Two heterozygous versions of undisputed haplotypes were found in 17.3% of participants: SU/BA in 10.8% and CA/BE in 6.5%. Conclusion As a result of sickle cell anemia, this investigation found changes in hematological parameters. In the Sudanese population, a new haplotype of the S gene was discovered.
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Affiliation(s)
- Tariq Osman Khalafallah
- Department of Hematology, Faculty of Medical Laboratory Sciences, Kordofan University, Kordofan, Sudan
| | | | - Asaad Ma Babker
- Department of Medical Laboratories Science, College of Health Science, Gulf Medical University, Ajman, UAE
| | - Abdulkarim S Bin Shaya
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Abdulaziz Alfahed
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Nahed S Alharithi
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Ghfren S Aloraini
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Hisham Ali Waggiallah
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
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Wonkam A, Munung NS, Dandara C, Esoh KK, Hanchard NA, Landoure G. Five Priorities of African Genomics Research: The Next Frontier. Annu Rev Genomics Hum Genet 2022; 23:499-521. [PMID: 35576571 DOI: 10.1146/annurev-genom-111521-102452] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To embrace the prospects of accurately diagnosing thousands of monogenic conditions, predicting disease risks for complex traits or diseases, tailoring treatment to individuals' pharmacogenetic profiles, and potentially curing some diseases, research into African genomic variation is a scientific imperative. African genomes harbor millions of uncaptured variants accumulated over 300,000 years of modern humans' evolutionary history, with successive waves of admixture, migration, and natural selection combining with extensive ecological diversity to create a broad and exceptional genomic complexity. Harnessing African genomic complexity, therefore, will require sustained commitment and equitable collaboration from the scientific community and funding agencies. African governments must support academic public research and industrial partnerships that build the necessary genetic medicine workforce, utilize the emerging genomic big data to develop expertise in computer science and bioinformatics, and evolve national and global governance frameworks that recognize the ethical implications of data-driven genomic research and empower its application in African social, cultural, economic, and religious contexts. Expected final online publication date for the Annual Review of Genomics and Human Genetics, Volume 23 is October 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; , , .,Current affiliation: McKusick-Nathans Institute of Genetic Medicine and Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;
| | - Nchangwi S Munung
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; , ,
| | - Collet Dandara
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; , ,
| | - Kevin K Esoh
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; , ,
| | - Neil A Hanchard
- Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA;
| | - Guida Landoure
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali;
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Ata F, Yousaf Z, Sardar S, Javed S, Iqbal P, Khamees I, Malkawi LS, Yassin MA. Protocol for "Genetic composition of sickle cell disease in the Arab population: A systematic review". Health Sci Rep 2022; 5:e450. [PMID: 35509404 PMCID: PMC9062566 DOI: 10.1002/hsr2.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 10/17/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sickle Cell Disease (SCD) is a global health issue in hematology with a progressively increasing prevalence. There are recent advances in the management of SCD, with new drugs being introduced. It is essential to analyze the genetic makeup of SCD regionally to anticipate the effectiveness of management modalities. This systematic review's main objectives are (a) to combine the existing knowledge of the genetic composition of SCD in the Arab population and (b) to analyze the various phenotypes of SCD prevalent in the Arab population. Methods We will perform a systematic review and search multiple electronic databases predefined search terms to identify eligible articles. Eligible studies should report findings on the genetic testing of Sickle Cell disease in the 22 Arab countries. Case reports, case series, observational studies with cross‐sectional or prospective research design, case‐control studies, and experimental studies will be included. Study quality will be independently evaluated by two reviewers using the statistical methodology and categories guided by the Cochrane Collaboration Handbook and PRISMA guidelines. Discussion This review will explore and integrate the evidence available on the various genotypes and phenotypes of SCD in the Arab population. By acquiring and summarizing data about the genetic and phenotypic variants of the SCD patient population, this study will add to the knowledge and help find more precise treatments. Systematic review registration The protocol is registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020218666).
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Affiliation(s)
- Fateen Ata
- Department of Internal Medicine Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Zohaib Yousaf
- Department of Internal Medicine Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Sundus Sardar
- Department of Internal Medicine Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Saad Javed
- Department of Internal Medicine Allama Iqbal Medical College Lahore Pakistan
| | - Phool Iqbal
- Department of Internal Medicine Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Ibraheem Khamees
- Department of Internal Medicine Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Lujain Salahaldeen Malkawi
- Department of Internal Medicine, Faculty of Medicine Jordan University of Science and Technology Irbid Jordan
| | - Mohamed A Yassin
- Department of Medical Oncology/Hematology National Centre for Cancer Care and Research, Hamad Medical Corporation Doha Qatar
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Adigwe OP, Onavbavba G, Onoja SO. Attitudes and practices of unmarried adults towards sickle cell disease: emergent factors from a cross sectional study in Nigeria's capital. Hematology 2022; 27:488-493. [PMID: 35430953 DOI: 10.1080/16078454.2022.2059629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Sickle cell disease is a genetic autosomal blood disorder that causes red blood cells to turn rigid and crescent shaped. The condition ultimately results to several complications leading to organ damage. This study aimed at assessing attitudes and practices of unmarried adults towards sickle cell disease. METHODS A cross sectional study was undertaken in the Nigerian Federal Capital Territory. Data were collected using a well-structured questionnaire. Descriptive and inferential statistics were undertaken. RESULTS Male and female participants were of a similar proportion as represented by 52% and 48%. The overall mean score for attitude towards sickle disease was 6.60 ± 2.583 (range; 0-11). A higher attitude score was observed among female participants (p = 0.012), older participants reported a better attitude towards sickle cell disease (p < 0.001), and level of education also influenced perception towards the disease (p < 0.001). Three-quarters of the participants (73.4%) supported the need for contextual legislation to prohibit marriage between two sickle cell carriers. More than one-tenth of the sample (14.4%) indicated that they would marry someone with sickle cell disease irrespective of their own genotype. Whilst two-thirds of the study participants (67.1%) indicated that they would prioritise sickle cell screening in their relationships, a third of them (33.3%) expressed a contrary standpoint. CONCLUSION Findings emanating from this research can guide Government and other critical Stakeholders in developing contextual policies and practices that will reduce the burden of sickle cell disorder.
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Affiliation(s)
- Obi Peter Adigwe
- National Institute for Pharmaceutical Research and Development, Idu Industrial District, Abuja, Nigeria
| | - Godspower Onavbavba
- National Institute for Pharmaceutical Research and Development, Idu Industrial District, Abuja, Nigeria
| | - Solomon Oloche Onoja
- Department of Medical Laboratory Sciences, University of Nigeria, Enugu, Nigeria
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Kanma-Okafor OJ, Abolarinwa AO, Ojo OY, Ekanem EE. Sickle cell disease prevention: How prepared are the senior secondary school students in Surulere Local Government Area, Lagos, Nigeria? Afr J Prim Health Care Fam Med 2022; 14:e1-e7. [PMID: 35532108 PMCID: PMC9082239 DOI: 10.4102/phcfm.v14i1.3260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/28/2021] [Accepted: 12/02/2021] [Indexed: 11/07/2022] Open
Abstract
Background Sickle cell disease (SCD), a common hereditary disease, can be prevented by preparing young people ahead of the conception of an affected foetus. Aim To assess the knowledge and attitude regarding SCD amongst senior secondary school students in Surulere Local Government Area (LGA), Lagos, Nigeria. Setting Senior secondary schools in Surulere LGA. Methods This was a descriptive cross-sectional study amongst 300 senior secondary school students. Data were collected using a self-administered questionnaire and analysed using Stata16. The Chi-square and Fisher’s exact tests were used to determine the association between categorical variables. The level of significance was predetermined at p < 0.05. Results The mean age of the respondents was 15.2 (±1.3) years, with a male-to-female ratio of about 1:2. The majority (90.0%) of the respondents were aware of SCD, 63.0% had good knowledge, although less than half of them (46.3%) knew SCD to be a blood disorder, whilst about two-thirds (53.1%) knew that it was an inherited condition. About one fifth (24.4%) of them knew about prevention by genetic counselling. The majority (97.0%) of them had a positive attitude towards SCD. Over two-thirds (72.6%) were aware of their genotype. The prevalence of SCD was 2.0%, whilst 18.9% of them were carriers of the sickle cell trait. Knowing their SCD status but not necessarily their genotype was significantly associated with their attitude towards the disease (p = 0.014). Conclusion The prevention of SCD was not known to the majority, and better attitudes were more likely when the SCD status was known. Therefore, routine screening and counselling could potentially aid SCD control.
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Affiliation(s)
- Oluchi J Kanma-Okafor
- Department of Community Health and Primary Care, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos.
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Yousif M, Abdelrahman A, Al Jamea LH, Al-Yami FS, Woodman A. Psychosocial Impact of Sickle Cell Disease and Diabetes Mellitus on Affected Children and Their Parents in Khartoum State, Sudan. J Trop Pediatr 2022; 68:6596143. [PMID: 35641127 DOI: 10.1093/tropej/fmac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to assess the psychosocial impact of sickle cell disease (SCD) and diabetes mellitus on children and their parents in Sudan, and the relationship between socioeconomic status and psychosocial issues. A descriptive, cross-sectional study was conducted among n = 320 children aged 6-12 years, of whom n = 170 were diagnosed with SCD, n = 150 children with diabetes mellitus and their parents. The strengths and difficulties questionnaire (SDQ scale) was used to assess the psychosocial aspect of children. Depression, Anxiety, Stress Scale -21 Items (DASS 21) was used to assess the psychological well-being of the caregivers. Data on psychological problems of children with SCD showed that 66.5% had emotional symptoms, 18.2% had conduct problems and 19.4% hyperactivity. Data of parents showed that 45.9% of parents did not experience depression; 27.9% were moderately depressed group. Data on psychological problems among children with diabetes showed that 57.3% experienced emotional symptoms, conduct problems were close to the average among 66%. Data on psychological problems among parents of children with diabetes showed that 45.3% of parents did not experience depression; 22.7% belonged to the moderately depressed group. Psychosocial problems were common both among children and parents. More research is needed in the context of caring for a child with chronic diseases and the role of health care providers in adapting and mitigating psychological problems among both parents and children.
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Affiliation(s)
- Magda Yousif
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Abdalla Abdelrahman
- Psychiatric Department, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Lamiaa H Al Jamea
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Fatimah S Al-Yami
- Department of Medical Laboratory, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Alexander Woodman
- Vice Deanship of Postgraduate Studies and Research, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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Molecular Analysis of Xmn1-Polymorphic Site ´5 to Gγ of the β-Globin Gene Cluster in a Saudi Population of Jazan Region in Correlation with Hb F Expression. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1717207. [PMID: 35356246 PMCID: PMC8959949 DOI: 10.1155/2022/1717207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/30/2021] [Accepted: 02/09/2022] [Indexed: 11/17/2022]
Abstract
The southern part of Saudi Arabia has an ethnically diverse population where sickle-cell anemia (sickle cell disease) is common, but little is known about its βs haplotypes. The goal of the current study is to ascertain the prevalence of the Hb S gene with analysis of Xmn1 ′5 to Gγ haplotype among the Saudi population in the Jazan area. Initially recorded findings of (1) Hb S gene and (2) hematological parameters with Hb F levels were collected from 5990 participants. Then, the second series of 70 different patients with established sickling disease and 30 healthy individuals as a control group was recruited, in which the genotype of Xmn1 ′5 to Gγ-SNP was performed by PCR-RFLP. In the first series, the prevalence of Hb types was AA at 86.8% (N = 5198), AS at 12.4% (N = 745), and SS at 0.8% (N = 47). Of the second series, three patients (4.3%) were (±) Xmn1 ′5 to Gγ and 67 (95.7%) were (−/−) in Xmn1 ′5 to Gγ. In the controls, the (±) Xmn1 ′5 to Gγ was observed in only one individual (3.3%), aged 30. These findings possibly represent a new Saudi haplotype, [±] Xmn1 ′5 to Gγ. Our results demonstrate that most patients with SCD in Jazan have [−/−] Xmn1 with higher levels of Hb F and positive Xmn1 ′5 to Gγ normally associated with a low level of Hb F.
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Pediatric Sickle Cell Disease in Sudan: Complications and Management. Anemia 2022; 2022:3058012. [PMID: 35198244 PMCID: PMC8860554 DOI: 10.1155/2022/3058012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Sickle cell disease (SCD) is a life-threatening genetic disorder due to the formation of sickle hemoglobin molecule (HbS) that polymerizes in hypoxic conditions leading to SCD-related complications. Different approaches have been used in the management of SCD including symptomatic management, supportive management, and preventive management. Objectives. To assess the management of SCD in pediatric patients in Gaafar Ibnauf Referral Hospital in Khartoum locality, Sudan. Method. A descriptive, retrospective, hospital-based study was conducted in Gaafar Ibnauf Hospital using a data collection sheet. The study included all medical files of pediatric patients with SCD attending the hospital during the period from the first of April 2018 to the first of July 2018. The data were analyzed using descriptive statistics and the chi-square test.
was considered statistically significant. Results. Out of 207 pediatric patients, 53.1% were females (mean age of 7.5 ± 3.1 years), with a 1.1 : 1 female:male ratio and low socioeconomic status. Only 4.3% of participants had health insurance. The Messeryia tribe in western Sudan had the highest prevalence of the disease among the Sudanese tribes (11.1%). Vaso-occlusive crisis (33.3%), infections (13.5%), and neurological complications (10.6%) were the most frequent complications reported during routine visits. After initiation of management, only 3.4% of pediatric patients had hemolytic crises, and 1.4% of the anemic patients had splenomegaly. 100% of patients received folic acid, 73.9% used hydroxyurea, and 69.6% underwent blood transfusion for the management of SCD. Prophylactic penicillin was prescribed for 15% of patients, and 41.1% were immunized with pneumococcal vaccine (PPSV23). Most patients had been scheduled for planned follow-up visits every 3–6 months (93.2%). Hydroxyurea and blood transfusion significantly reduced fever and vaso-occlusive crisis. Conclusion. The SCD treatment protocol in Gaafar Ibnauf Children’s Hospital, involving preventive and symptomatic therapy, is consistent with the internationally implemented protocols for SCD management. However, immunization and prophylactic penicillin approaches are deficient.
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Baitalmal L, Al Kasim F, Ghareeb E, Azmet F, Jaganathan P. Relationship between genotype variants and the age of first acute splenic sequestration in patients with sickle cell disease in a tertiary center of Saudi Arabia: A retrospective study. JOURNAL OF APPLIED HEMATOLOGY 2022. [DOI: 10.4103/joah.joah_244_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Rocha R, Souza TVD, Morais RDCMD, Nascimento LDCN, Couto LLD, Farias IFDA. (Lack of) knowledge of mothers about sickle cell trait and disease: a qualitative study. Rev Bras Enferm 2021; 75:e20201217. [PMID: 34495132 DOI: 10.1590/0034-7167-2020-1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the understanding of mothers about sickle cell disease and/or trait of the family from a diagnosed child. METHODS this is a qualitative study, using a semi-structured interview with 23 mothers, at a sickle cell disease outpatient clinic of a public institution, from October to December 2017. Analysis was thematic. RESULTS all participants had sickle cell trait as well as the parents of their children. Twenty children were diagnosed with sickle cell disease by Heel Prick Test, and three, after hospitalization due to the disease. Most did not know how to report the presence of the trait or disease in relatives other than nuclear. FINAL CONSIDERATIONS diagnosis cannot be restricted to the result of neonatal screening, requiring that preventive information on sickle cell crises be reinforced. It is recommended to search for other affected relatives to learn about their genetic condition, reflecting on their reproductive decisions.
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Affiliation(s)
- Rafael Rocha
- Instituto de Pediatria e Puericultura Martagão Gesteira. Rio de Janeiro, Rio de Janeiro, Brazil
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Babu BV, Sridevi P, Surti S, Ranjit M, Bhat D, Sarmah J, Sudhakar G, Sharma Y. Inadequate community knowledge about sickle cell disease among the Indian tribal population: a formative assessment in a multicentric intervention study. Trans R Soc Trop Med Hyg 2021; 115:1434-1444. [PMID: 34037804 DOI: 10.1093/trstmh/trab075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/12/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a serious public health problem, with >300 000 affected births worldwide each year. About 73% of the SCD-affected people in India belong to the tribal population. The Government of India is planning to implement a programme for SCD and hence people's knowledge of SCD is crucial. This paper reports the SCD-related knowledge among the Indian tribal population. METHODS As part of a formative assessment before an intervention, data were collected from 9837 adults from 24 primary health centre areas of six states. Each community's knowledge of SCD was elicited through an interviewer-administered pretested questionnaire. Univariate and multivariate analyses were conducted. RESULTS Overall, 32.1% (CI 31.2 to 33.1%) of participants had heard of SCD, 7.9% (CI: 7.3 to 8.4%) knew that SCD is hereditary, 19.4% (CI: 18.7 to 20.3%) knew that a blood test can diagnose SCD and 23.9% (CI: 23.1 to 24.8%) knew that SCD is treatable. Only 13.1% (CI: 12.4 to 13.8%) knew that SCD can be prevented. No more than 16% knew about any SCD symptoms. Multiple logistic regression revealed some predictors of basic knowledge (i.e. had heard of SCD). CONCLUSIONS There is a gross inadequacy of knowledge about SCD in the Indian tribal population. This study warrants implementing a health education programme as a part of the SCD programme.
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Affiliation(s)
- Bontha V Babu
- Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
| | - Parikipandla Sridevi
- Department of Biotechnology, Indira Gandhi National Tribal University, Amarkantak, India
| | - Shaily Surti
- Department of Community Medicine, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, India
| | - Manoranjan Ranjit
- Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, India
| | - Deepa Bhat
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Jatin Sarmah
- Department of Biotechnology, Bodoland University, Kokrajhar, India
| | - Godi Sudhakar
- Department of Human Genetics, Andhra University, Visakhapatnam, India
| | - Yogita Sharma
- Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
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Ali EH, Alkindi S, Osman MA, Hilali W, Mirgani HM, Adam G, Morsi MM, Hussein IS, Ghebremeskel K. Nutritional and Hematological Status of Sudanese Women of Childbearing Age with Steady-state Sickle Cell Anemia. Oman Med J 2021; 36:e270. [PMID: 34164159 PMCID: PMC8204634 DOI: 10.5001/omj.2021.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/11/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES We sought to investigate the nutritional and hematological status of Sudanese women of childbearing age with sickle cell anemia (SCA). Anthropometry and hematology were used to assess nutritional status and health and disease conditions, respectively. METHODS Women with steady-state (HbSS, n = 39; age = 19.0±2.7) and without (HbAA, n = 36; age, 19.8±2.7) SCA were recruited during a routine visit to the Hematology Clinic, Ibn-Auf Teaching Hospital, Khartoum, Sudan. RESULTS The two groups of women lived in similar environmental conditions and ate similar diets three times a day. However, despite taking regular meals, the women with sickle anemia were thinner and lighter (p < 0.001) and shorter (p = 0.002) compared with those who do not have the disease. Also, they had higher levels of mean corpuscular hemoglobin (Hb) concentration and white cell count (p < 0.001), mean corpuscular volume (p = 0.003), and platelet (p = 0.002) and lower packed cell volume and Hb (p < 0.001). There was no difference in levels of anthropometric and hematological variables between the hydroxyurea treated and untreated SCA patients (p > 0.050). CONCLUSIONS The low anthropometric (height, weight, and body mass index) and abnormal hematological values in the women with SCA in steady-state reflect sustained nutritional insults inflected by the disease and poverty. Tailored nutritional counseling/advice must be an integral part of managing patients with SCA. Such advice is particularly vital for women of childbearing age because of the adverse effects of prepregnancy nutritional deficiency on outcomes.
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Affiliation(s)
- Eltigani Hassan Ali
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, London, UK
| | - Salam Alkindi
- Department of Hematology, Sultan Qaboos University, Muscat, Oman
| | - Mohamed A. Osman
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Wafa Hilali
- Department of Haematology, Ibn Auf Teaching Hospital, Khartoum, Sudan
| | - Hind M. Mirgani
- Department of Haematology, Ibn Auf Teaching Hospital, Khartoum, Sudan
| | - Gareeba Adam
- Department of Educational Technology, Faculty of Higher Studies, Al-Zaiem Al Azhari University, Khartoum, Sudan
| | - Magdi M. Morsi
- Directorate of Planning, Ministry of Health, Muscat, Oman
| | - Izzeldin S. Hussein
- Department of Micronutrient, Iodine Global Network, Middle East and North Africa
| | - Kebreab Ghebremeskel
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, London, UK
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Comparative study of risk factors in young adults and elderly stroke patients in Sudan. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bukini D, Nkya S, McCurdy S, Mbekenga C, Manji K, Parker M, Makani J. Perspectives on Building Sustainable Newborn Screening Programs for Sickle Cell Disease: Experience from Tanzania. Int J Neonatal Screen 2021; 7:ijns7010012. [PMID: 33652550 PMCID: PMC7930989 DOI: 10.3390/ijns7010012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022] Open
Abstract
The prevalence of sickle cell disease is high in Africa, with significant public health effects on the affected countries. Many of the countries with the highest prevalence of the disease also have poor health care systems and a high burden of infectious diseases with many other competing health care priorities. Although considerable efforts have been made to implement newborn screening for sickle cell disease programs in Africa, coverage is still low. Tanzania has one of the highest birth prevalence of children with sickle cell disease in Africa. In 2015, the country implemented a pilot project for Newborn Screening for Sickle Cell Disease to assess feasibility. Several efforts have been made afterwards to continue providing the screening services as well as related comprehensive care services. Using qualitative methods, we conducted in-depth interviews and focus group discussions with policy makers (n = 4), health care providers (n = 21) and families (n = 15) to provide an analysis of their experiences and perspectives on efforts to expand and sustain newborn screening for sickle cell disease and related comprehensive care services in the country. Thematic content analysis was used to analyze the data through the framework analysis method. The findings have demonstrated both the opportunities and areas that need addressing in the implementation and sustainability of the services in low resource settings. A key area of strengthening is full integration of the services in countries' health care systems to facilitate the coverage, accessibility and affordability of the services. Although the coverage of newborn screening services for sickle cell disease is still low, efforts at the local level to sustain the implementation of the programs and related comprehensive care services are encouraging and can be used as a model for other programs implemented in low resources settings.
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Affiliation(s)
- Daima Bukini
- Sickle Cell Programme, Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, P.O. Box 65001 Dar es Salaam, Tanzania; (S.N.); (J.M.)
- Correspondence: or
| | - Siana Nkya
- Sickle Cell Programme, Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, P.O. Box 65001 Dar es Salaam, Tanzania; (S.N.); (J.M.)
- Department of Biological Sciences, Dar es Salaam University College of Education, P.O. Box 2329 Dar es Salaam, Tanzania
| | - Sheryl McCurdy
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Centre at Houston, School of Public Health, Houston, TX 77030, USA;
| | - Columba Mbekenga
- School of Nursing and Midwifery, Aga Khan University, P.O. Box 38129 Dar es Salaam, Tanzania;
| | - Karim Manji
- Department of Pediatrics & Child health, Muhimbili University of Health and Allied Sciences, P.O. Box 65001 Dar es Salaam, Tanzania;
| | - Michael Parker
- Welcome Centre for Ethics and Humanities, University of Oxford, Oxford OX3 7LF, UK;
| | - Julie Makani
- Sickle Cell Programme, Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, P.O. Box 65001 Dar es Salaam, Tanzania; (S.N.); (J.M.)
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Ngwengi NY, Fon PN, Mbanya D. Distribution of haemoglobin genotypes, knowledge, attitude and practices towards sickle cell disease among unmarried youths in the Buea Health District, Cameroon. Pan Afr Med J 2021; 37:109. [PMID: 33425142 PMCID: PMC7757270 DOI: 10.11604/pamj.2020.37.109.17864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/26/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction sickle cell disease (SCD) is one of the commonest genetic causes of morbidity and mortality in the world. In resource-limited settings, SCD prevention through public education and screening could be a significant strategy to curb its prevalence. The study aimed at determining the distribution of haemoglobin genotypes among unmarried youths in Buea, Cameroon as well as their knowledge, attitude and practices towards SCD. Methods a community-based, analytic, cross-sectional study was conducted within the city of Buea. Data was collected from 410 youths using self-administered questionnaires. Of the 410 youths, 100 were selected by purposive random sampling and their haemoglobin genotyping was done using haemoglobin electrophoresis. The data was analysed using the statistical software Epi Info Version 7. Results the majority (51.5%) of the 410 respondents were females. The modal age range was 18- 21 years (46.8%) and 60.4% had tertiary education. Less than one quarter (20.5%) had good knowledge of SCD. Only 13.2% knew their genotype and 59.3% were willing to avoid carrier marriages. Out of the 100 participants for genotyping, 84.0% had normal haemoglobin (HbAA) and 16.0% had the sickle cell trait (HbAS). Conclusion most of the respondents had moderate knowledge of SCD. Only a few knew their haemoglobin genotype and more than half were willing to avoid carrier marriages. The prevalence of sickle cell trait is high in Buea. The promotion of preventive methods like public education and genetic screening is recommended to reduce the burden of SCD in Cameroon.
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Affiliation(s)
- Nini Yesih Ngwengi
- Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, South West Region, Cameroon
| | - Peter Nde Fon
- Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, South West Region, Cameroon
| | - Dora Mbanya
- Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroun.,Haematology & Blood Transfusion Service, Yaoundé University Teaching Hospital, Yaoundé, Cameroon
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Caregivers’ level of knowledge and home- based practices for prevention of Sickle cell disease related complications among children attending Mnazi mmoja hospital in Zanzibar. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Ahmed MH, Abdalla ME, Taha MH. Why social accountability of medical schools in Sudan can lead to better primary healthcare and excellence in medical education? J Family Med Prim Care 2020; 9:3820-3825. [PMID: 33110774 PMCID: PMC7586598 DOI: 10.4103/jfmpc.jfmpc_498_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/25/2020] [Accepted: 05/21/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction: Medical education in Sudan continues to evolve and progress with proliferation in the number of medical schools after 1990. Social factors and the geographical location of Sudan will increase the opportunity of success of medical schools to be socially accountable. In this analysis, we explained why social accountability is needed in Sudan and how this can enhance both excellence in medical education and primary health care, especially in rural areas. Methodology: PubMed, scopus Medline, and Google Scholar were searched for published-English literature concerning social accountability of medical schools in Sudan and worldwide were reviewed regardless of the time limit. We have also included examples of medical schools from Sudan and the Middle East to reflect on their experience in social accountability. Results: In this critical review, we have shown that social accountability will come with benefits for medical schools and the community. Implementation of social accountability in medical schools in Sudan will increase the effectiveness of medical schools' productivity, research output, and health service in urban and rural areas. There is an urgent need for social accountability alliance in Sudan to increase collaboration between medical schools. This will increase the benefits of social accountability for all stakeholders and also increases the competency in social medicine within the medical school curriculum. Conclusion: Social accountability is regarded as a sign of excellence in medical education. Primary care physicians in Sudan are expected to be the leaders in the implementation of social accountability. This analysis answered two important questions about why medical schools in Sudan should be socially accountable? And do we need a special structure of social accountability in Sudan?
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Affiliation(s)
- Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
| | - Mohamed Elhassan Abdalla
- College of Medicine and Medical Education Center, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed H Taha
- College of Medicine and Medical Education Center, University of Sharjah, Sharjah, United Arab Emirates
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Influence of gender norms in relation to child's quality of care: follow-up of families of children with SCD identified through NBS in Tanzania. J Community Genet 2020; 12:143-154. [PMID: 32789668 DOI: 10.1007/s12687-020-00482-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023] Open
Abstract
Introducing newborn screening (NBS) services for sickle cell disease (SCD) in Africa has been proven to be one of the most cost-effective approach to reducing morbidity and mortality associated with this condition. In view of this evidence, efforts have been made by countries in Africa where SCD prevalence is high to pilot NBS programmes and to strengthen comprehensive care services for SCD. While it is important to reap the benefits of NBS for SCD in Africa in terms of overall quantitative measures, it is also important to understand how certain social and cultural conditions may disproportionately influence the outcomes of screening for some groups. The aim of this study was to analyse the role of gender norms before and after NBS for SCD in Tanzania, and to assess how they influence the quality of care of diagnosed children. Using qualitative methods, we did in-depth interviews with families of children with SCD identified through the NBS services and focus group sessions with nurses working in neonatal and postnatal sections of regional referral hospitals in Dar es Salaam. By analysing the experiences of both the families and nurses, we were able to provide evidence on, firstly, the gendered relations that undergird childcare and, secondly, how those relations influence the quality of care the child may potentially receive. The results emphasize the importance of studying the social implications of SCD in Africa, especially with regard to improving the quality of care for patients with SCD in the region. We propose simple interventions, including gender-conscious health education and genetic counselling, which can help to improve the community understanding of genetic diseases while also reducing gender-related inequalities related to SCD care in Africa.
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Gaffar AM, Magzoub MEM, Mahmoud I. Do community-based Medical Schools Produce More Community-based Research? A Review of Four Medical Schools in Sudan and Saudi Arabia. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Severe childhood anemia and emergency blood transfusion in Gadarif Hospital, eastern Sudan. PLoS One 2019; 14:e0225731. [PMID: 31794569 PMCID: PMC6890167 DOI: 10.1371/journal.pone.0225731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anemia is a major cause of global morbidity and mortality, particularly among children. Management of anemia depends on causes and severity of anemia. However blood transfusion is a lifesaving intervention in severe and life-threatening anemia. There are no published data on blood transfusion for anemia in Sudan. METHODS A descriptive study was conducted in Gadarif Hospital in eastern Sudan during 1 August, 2017 to 31 March, 2018. Consecutive children who presented at the emergency room with an indication for blood transfusion were enrolled in the study. A detailed history was gathered from all patients. Physical examinations, including vital signs, were performed. The World Health Organization guidelines for blood transfusion were followed. RESULTS During the study period, a total of 1800 children were admitted to the emergency pediatric ward in Gadarif Hospital and were assessed for anemia, 513 (28.5%) were anemic and 141 (7.8%) had severe anemia. Three hundred anemic children received blood transfusion. The median (interquartile) of the age of the 300 children who received blood transfusion was 4.2 4.2(2.0-9.0) years. A total of 148 (49.3%) of the children were boys and 151 (50.3%) were younger than 5 years. The diagnoses associated with the order for blood transfusion were sickle cell disease (129, 43.0%), active bleeding (58, 19.3%), malaria (50, 16.7%), visceral leishmaniasis (25, 8.3%), severe acute malnutrition (16, 5.30%), snake bite (11, 3.7%), sepsis (5, 1.7%), and others. Two hundred eighty-five (95.0%) children improved, nine children were discharged against medical advice, and six (2.0%) children died. CONCLUSION There is a high burden of anemia in eastern Sudan. Sickle cell disease, malaria, and visceral leishmaniasis are the main causes of anemia in this region. Further research on blood transfusion is needed.
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Adam MA, Adam NK, Mohamed BA. Prevalence of sickle cell disease and sickle cell trait among children admitted to Al Fashir Teaching Hospital North Darfur State, Sudan. BMC Res Notes 2019; 12:659. [PMID: 31619285 PMCID: PMC6796395 DOI: 10.1186/s13104-019-4682-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/28/2019] [Indexed: 01/28/2023] Open
Abstract
Objective It is estimated that 50% to 90% of infants born with (SCA) in sub-Saharan Africa die before 5 years old. Northern Darfur State at western Sudan region has a multiethnic population with a high frequency of sickle cell anaemia, but little about it is published. This study aimed to determine the prevalence of sickle cell anaemia among children admitted to Al Fashir Teaching Hospital in Al Fashir, Northern Darfur State, Sudan. Results The prevalence of sickle cell disease by haemoglobin electrophoresis among these 400 children patients was 59 (14.8%). Sickle cell trait patients were 11.3% and Sickle cell disease positive patients were 3.5%. Individuals with SCA have consistently low blood Hb concentration, normal MCV and high mean WBC’s. Individuals with sickle cell trait had haematological parameters near to those of normal individuals.
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Affiliation(s)
- Mudathir A Adam
- Faculty of Medical Laboratory Science, Al Fashir University, Al Fashir, Sudan.
| | - Nassreldeen K Adam
- Faculty of Medical Laboratory Science, Al Fashir University, Al Fashir, Sudan
| | - Babiker A Mohamed
- Pathology Department, Faculty of Medicine, Karari University, Khartoum, Sudan
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Al-Qattan HM, Amlih DF, Sirajuddin FS, Alhuzaimi DI, Alageel MS, Bin Tuwaim RM, Al Qahtani FH. Quantifying the Levels of Knowledge, Attitude, and Practice Associated with Sickle Cell Disease and Premarital Genetic Counseling in 350 Saudi Adults. Adv Hematol 2019; 2019:3961201. [PMID: 31186651 PMCID: PMC6521475 DOI: 10.1155/2019/3961201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/24/2019] [Accepted: 04/23/2019] [Indexed: 02/02/2023] Open
Abstract
Our study aims to observe the levels of knowledge, attitude, and practice (KAP) associated with sickle cell disease (SCD) and premarital genetic counseling (PMGC) in 351 Saudi adults. The relationships between KAP levels and sociodemographic characteristics (age, gender, marital status, and educational level) were observed. The study was conducted in King Khalid University Hospital between February 21, 2017, and March 7, 2018. A total of 351 Saudi participants attending the primary care clinic were selected using convenience sampling and were given a self-administered questionnaire. Overall, the 351 participants had the best attitude (41% scoring "good"), followed by knowledge (28.8%), and, lastly, practice (19.1%). Out of the sociodemographic characteristics, age group was the most statistically significant in all the three categories (knowledge, attitude, and practice). The > 50-year age group performed the worst in all the three categories. Despite the advancements in public healthcare measures in Saudi Arabia, our study revealed that there are still many gaps to be filled regarding the knowledge, attitude, and practice associated with SCD and PMGC.
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Affiliation(s)
- Heba M. Al-Qattan
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Dana F. Amlih
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | | | | | - Mai S. Alageel
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | | | - Farjah H. Al Qahtani
- Division of Oncology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Asymmetric Dimethylarginine Levels and Its Correlation to Cerebral Blood Flow in Children with Sickle Cell Anemia. Indian J Hematol Blood Transfus 2019; 35:742-749. [PMID: 31741631 DOI: 10.1007/s12288-019-01109-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/03/2019] [Indexed: 01/19/2023] Open
Abstract
Asymmetric dimethylarginine (ADMA) level may play a role in the pathogenesis of cerebrovascular stroke in Children with Sickle Cell Anemia (SCA). To assess the plasma level of ADMA in children with SCA and its correlation to cerebral blood flow. This is a cross sectional study was carried out on 30 children with homozygous SCA under follow up in the Out Patients Clinic, Pediatric Department at Tanta University Hospital and 30 healthy children as a control group. Both groups had undergone the following investigations: Complete blood count, lactate dehydrogenase enzyme, and plasma level of ADMA by a commercial ADMA ELISA Kit. Trans-cranial Doppler were done for both groups. ADMA plasma level was significantly higher in-patient group in comparison to the control group (p < 0.001), with a mean value 1.43 ± 0.20 μmol/l, 0.48 ± 0.16 μmol/l respectively. The time-averaged mean maximum velocities for middle cerebral artery, anterior cerebral artery, inferior cerebral artery and posterior cerebral artery were significantly different between patient and control group, p < 0.05. Trans-cranial Doppler data revealed that, 86.7% of patients have low velocity (< 70 cm/s) and 13.3% having very low velocity (< 10 cm/s) while control group have normal velocity. There was a significant negative correlation between ADMA plasma levels and cerebral blood flow. Elevated ADMA levels may have a role in the pathogenesis of the decreased cerebral blood flow in children with SCA.
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Biological impact of α genes, β haplotypes, and G6PD activity in sickle cell anemia at baseline and with hydroxyurea. Blood Adv 2019; 2:626-637. [PMID: 29555644 DOI: 10.1182/bloodadvances.2017014555] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/20/2018] [Indexed: 12/17/2022] Open
Abstract
Sickle cell anemia (SCA), albeit monogenic, has heterogeneous phenotypic expression, mainly related to the level of hemoglobin F (HbF). No large cohort studies have ever compared biological parameters in patients with major β-globin haplotypes; ie, Senegal (SEN), Benin (BEN), and Bantu/Central African Republic (CAR). The aim of this study was to evaluate the biological impact of α genes, β haplotypes, and glucose-6-phosphate dehydrogenase (G6PD) activity at baseline and with hydroxyurea (HU). Homozygous HbS patients from the Créteil pediatric cohort with available α-gene and β-haplotype data were included (n = 580; 301 females and 279 males) in this retrospective study. Homozygous β-haplotype patients represented 74% of cases (37.4% CAR/CAR, 24.3% BEN/BEN, and 12.1% SEN/SEN). HU was given to 168 cohort SCA children. Hematological parameters were recorded when HbF was maximal, and changes (ΔHU-T0) were calculated. At baseline, CAR-haplotype and α-gene numbers were independently and negatively correlated with Hb and positively correlated with lactate dehydrogenase. HbF was negatively correlated with CAR-haplotype numbers and positively with BEN- and SEN-haplotype numbers. The BCL11A/rs1427407 "T" allele, which is favorable for HbF expression, was positively correlated with BEN- and negatively correlated with CAR-haplotype numbers. With HU treatment, Δ and HbF values were positively correlated with the BEN-haplotype number. BEN/BEN patients had higher HbF and Hb levels than CAR/CAR and SEN/SEN patients. In conclusion, we show that BEN/BEN patients have the best response on HU and suggest that this could be related to the higher prevalence of the favorable BCL11A/rs1427407/T/allele for HbF expression in these patients.
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Karadağ G, Güngörmüş Z, Olçar Z. Experiences and Problems Encountered by Families of Children with Sickle Cell Anemia. J Caring Sci 2018; 7:125-129. [PMID: 30283756 PMCID: PMC6163154 DOI: 10.15171/jcs.2018.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/02/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction: Sickle Cell Anemia is a disease that has a high level of morbidity and early mortality for patients that are not followed and controlled properly. Study was conducted the aim of determining experiences and problems of families whose children with sickle cell anemia. Methods: Descriptive study was conducted the aim of determining experiences and problems of families (n= 206) whose children with sickle cell anemia. Before conducting this study, a written permission from the related institution and research ethics committee approval from Gaziantep University were obtained. Questionnaire is made up of two sections (10 questions), socio-demographic of families and data about their problems (15 questions and 11 statements). Data were evaluated SPSS (21.0), number and percentage calculations. Results: It was determined that 96.1% of participants knew nothing about disease before their children were diagnosed, 92.7% of them are aware the disease was genetically inherited, all participants were a disease carrier themselves, and 93.7% of them had no blood tests before marriage. 97.1% of participants have no support from their spouses, It was determined that 98.5% of children suffer from pain, 60.7% suffer from weakness 51.5% of the participants apply to hospitals to decrease the problems and 48.5% use medications at home. Conclusion: A great number of families have problems regarding fear of losing their children, lack of social aid and support. Majority of children suffer from pain, weakness, exhaustion, they stay at hospital between at least 1 and 5 times a year, they need blood transfusion.
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Affiliation(s)
- Gülendam Karadağ
- Department of Public Health Nursing, Faculty of Nursing, Dokuz Eylül University, İzmir, Turkey
| | - Zeynep Güngörmüş
- Department of Public Health Nursing, Faculty of Health Sciences, University of Gaziantep, Gaziantep, Turkey
| | - Zeynep Olçar
- Department of Heamotology and Oncology, Nurse of University Hospital, Mustafa Kemal University, Hatay, Turkey
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